The official record vs. The hidden reality of suicide

Dr. Ong Kian Ming, MP of Serdang recently asked the government for the annual rate of suicides in Malaysia. This week in parliament, the government reported that 1513 suicides were recorded from 2010 to September 2016, or on average 227 people a year. This means one person every 2 days commits suicide. This is the official record.

There is no record of attempted suicides in Malaysia. A study based on The National Suicide Registry Malaysia in 2009 reported that 15% of completed suicides made at least one prior attempted suicide. However, this was based on family reporting and 26% of the sample did not provide a response. If we assume that 227 people who committed suicide represent 85% of attempted suicide, this means that in total there is at least 267 people who had attempted suicide.

There are many reasons why a suicide is not recorded on the death certificate as a suicide or why attempted suicides were not reported including:

“Whoever attempts to commit suicide, and does any act towards the commission of such offence, shall be punished with imprisonment for a term which may extend to one year or with fine or with both”

This brings to question whether the official statistics actually portrays the true picture of suicide in Malaysia.

THE HIDDEN REALITY

A more accurate estimate of the number of suicides in Malaysia is 12 people per 100 000 per year1. This works out to be approximately 3600 suicides per year (based on a population estimate of 30 million).

10 people per day commit suicide

NOT

1 person every 2 days

That is 20 times higher than the official suicide record.

But this number only accounts for completed suicides. What about attempted suicides in Malaysia?

This is a ratio of 1:25 completed to attempted suicide i.e. for every 1 person who committed suicide, 24 more people tried to end their lives.

Consider this:

The Ministry of Health reported that in 2015, 30% of Malaysians are suffering from mental health problems. 9 000 000 people in Malaysia are in psychological distress right now. 6.3 % or 1 890 000 Malaysians are thinking about death and suicide. 250 of them will decide that they can no longer go on.

Of the 250 people who will attempt to commit suicide today, 188 of them are suffering from a mental illness.

The threat of imprisonment is neither an effective nor a compassionate answer to our people’s cry for help. These are Malaysians who have reached the end of their rope and they see no other way out than to end their lives. They feel helpless and hopeless about their life circumstances. Yet the government looks at the official numbers, ignoring the research that shows the prevalence of suicide is much higher than what is officially recorded and deems that Section 309 of the Penal Code is effective in preventing suicide. Whilst it may be effective in covering up the hidden reality and seeing the state of our nation through rose coloured lenses, it is not effective in addressing the real issue of suicide. The cost of this rosy picture is that Malaysians do not and will not get the help that they need. Treatment not incarceration is needed. Our laws must be reformed to reflect a more informed and compassionate view of suicide and of mental illness.

Our first Prime Minister, Tunku Abdul Rahman said this on 31 August 1957, Independence Day:

At this solemn moment therefore I call upon you all to dedicate yourselves to the service of the new Malaya: to work and strive with hand and brain to create a new nation, inspired by the ideals of justice and liberty-a beacon of light in a disturbed and distracted world.

Our world is disturbed and distracted still, and increasingly so. We are not treating people who suffer from a mentally illness justly. Rather than being a beacon of light in their time of darkness, we shame them and threaten them with imprisonment.

1Dr. Maniam, a national expert on suicide research argues that there is a systematic misclassification of medically certified suicides. Rather than recording a suicide as a suicide, it is wrongly recording as “violent deaths not known to be accidentally or deliberately inflicted”. The number of medically certified suicides decreased from 6.1 per 100 000 people (from 1966-1974) to 1.6 per 100 000 people (from 1975-1990) while there was a corresponding increase in the number of undetermined violent deaths from 1 per 100 000(from 1966-1974) to 6 per 100 000 people (from 1975-1990).

The estimated prevalence of suicide of 12 per 100 000 people is comparable to the official prevalence of completed suicide in Singapore of 8-10 per 100 000 people.